<!DOCTYPE html>
<html>
	<head>
		<title>
			User Information
		</title>
		
		<meta charset="utf-8">
		<link rel="stylesheet" href="css/structure.css" type="text/css" />
		<link rel="stylesheet" href="css/form.css" type="text/css" />
		<link rel="stylesheet" href="css/navigation.css" type="text/css" />

		<script src="js/info.js"></script>
	</head>

	<body id="public">
		{{ nav|safe }}
		<div id="container" class="ltr">
			<form id="form" name="form" class="wufoo topLabel page" method="post" action="/info">
			
				<header id="header" class="info">
					<h1>{{ comper }}</h1>
					
					<h2>User Information</h2>
	
					<div>
						Please fill out your information. All fields are required.
						<br/>
						<br/>
						Email will be sent to the address provided.
						<br/>
						Phone numbers will be used only in case of emergencies.
						<br/>
						<br/>
						Don't mess this up.
					</div>
				</header>
				
				<ul>
					<li class="">
						<label class="desc" for="name">
							First and Last Name
							<span class="req">*</span>
							<!-- {% if name %}{{ name }}{% endif %}  -->
						</label>
						<div>
							<input id="name" name="name" type="text" class="field text medium" value="{% if name %}{{ name }}{% endif %}" maxlength="255" tabindex="1" onkeyup="" required />
						</div>
					</li>
					
					<li class="">
						<label class="desc" for="email">
							Email
							<span class="req">*</span>
							<!-- {% if email %}{{ email }}{% endif %}  -->
						</label>
						<div>
							<input id="email" name="email" type="email" spellcheck="false" class="field text medium" value="{% if email %}{{ email }}{% endif %}" maxlength="255" tabindex="2" required /> 
						</div>
					</li>
					
					<li class="phone">
						<label class="desc" for="phone">
							Phone Number
							<span class="req">*</span>
							<!-- {% if phone %}{{ phone }}{% endif %}  -->
						</label>
						
						<span>
							<input id="phone-0" name="phone-0" type="tel" class="field text" value="{% if phone0 %}{{ phone0 }}{% endif %}" size="3" maxlength="3" tabindex="3" required />
							<!--
							<label for="phone-0">###</label>
							-->
						</span>
						<span class="symbol">-</span>
						<span>
							<input id="phone-1" name="phone-1" type="tel" class="field text" value="{% if phone1 %}{{ phone1 }}{% endif %}" size="3" maxlength="3" tabindex="4" required />
							<!-- 
							<label for="phone-1">###</label>
							-->
						</span>
						<span class="symbol">-</span>
						<span>
							<input id="phone-2" name="phone-2" type="tel" class="field text" value="{% if phone2 %}{{ phone2 }}{% endif %}" size="4" maxlength="4" tabindex="5" required />
							<!--
							<label for="phone-2">####</label>
							-->
						</span>
					</li>
					
					<li class="">
						<fieldset>
							<legend id="title6" class="desc">
								Year
								<span class="req">*</span>
								<!-- {% if year %}{{ year }}{% endif %}  -->
							</legend>
							<div>
								<span>
									<input id="year_0" name="year" type="radio" class="field radio" value="1" tabindex="6" {% if year %}{% ifequal year 'Freshman' %}checked{% endifequal %}{% endif %} required />
									<label class="choice" for="year_0" >
										Freshman
									</label>
								</span>
								<span>
									<input id="year_1" name="year" type="radio" class="field radio" value="2" tabindex="7" {% if year %}{% ifequal year 'Sophomore' %}checked{% endifequal %}{% endif %} required />
									<label class="choice" for="year_1" >
										Sophomore
									</label>
								</span>
								<span>
									<input id="year_2" name="year" type="radio" class="field radio" value="3" tabindex="8" {% if year %}{% ifequal year 'Junior' %}checked{% endifequal %}{% endif %} required />
									<label class="choice" for="year_2" >
										Junior
									</label>
								</span>
								<span>
									<input id="year_3" name="year" type="radio" class="field radio" value="4" tabindex="9" {% if year %}{% ifequal year 'Senior' %}checked{% endifequal %}{% endif %} required />
									<label class="choice" for="year_3" >
										Senior
									</label>
								</span>
							</div>
						</fieldset>
					</li>
					
					<li class="">
						<label class="desc" id="title14" for="house">
							Dorm/House and Room
							<span id="req_14" class="req">*</span>
							<!-- {% if house %}{{ house }}{% endif %}   -->
						</label>
						<div>
							<input id="house" name="house" type="text" class="field text medium" value="{% if house %}{{ house }}{% endif %}" maxlength="255" tabindex="10" onkeyup="" required />
						</div>
					</li>
					
					<li class="">
						<label class="desc" id="title14" for="pw">
							Registration Password
						</label>
						<div>
							<input id="pw" name="pw" type="password" class="field text medium" value="" maxlength="255" tabindex="11" onkeyup=""/>
						</div>
					</li>
					
					<li class="buttons">
						<div>
							<input id="saveForm" name="saveForm" class="btTxt submit" type="submit" value="Submit" />
						</div>
					</li>
				
				</ul>
			</form> 
		</div>
	</body>
</html>